Evaluation of Effect of CryoBalloon Focal Ablation System on Human Esophageal Barrett's Epithelium

• Post-procedure pain relative [ Time Frame: Pre-ablation,12 hrs post ablation, 2 days (+ or - 1 day) ] [ Designated as safety issue: Yes ]
  A secondary objective of the study is to determine patient comfort post-procedure. Pain scores are measured on a numerical pain intensity scale (0 to 10). Patients is asked to score pain level in the treatment area and swallowing.
• Presence of Residual Barrett's Esophagus [ Time Frame: 6 to 8 weeks ] [ Designated as safety issue: No ]

  Esophageal tissue subjected to ablation via the CryoBalloon Focal Ablation System will be submitted for histological evaluation. The evaluation will include:

  1. detailed description of the presence of Barrett's Esophagus and/or squamous mucosa.
  2. estimate of percentage of residual Barrett's in each sample
  3. the detailed description of any residual injury at all levels within the sample.

This is a feasibility study without a primary study hypothesis or statistical comparison.

The purpose of this study is to assess the safety, feasibility, and performance of the C2 Focal Cryoablation Device in patients with Barrett's Esophagus (BE). At 6 to 8 weeks, the patient will receive a follow-endoscopy to assess stricture formation along with biopsy samples taken.

Post-operative pain will be noted. Additionally, biopsy samples will be evaluated for the presence of residual Barrett's Esophagus. Through evaluation of the histological results, treatment parameters for the ablation of human esophageal epithelium will be better understood.

Evaluations include, but are not limited to the following:

• Deployment ease/scope compatibility.
• Device malfunctions.
• Time of catheter deployment.
• Adverse events.
• Stricture formation at 6 to 8 weeks.
• Patient Pain.
• Histological evaluation of treatment zone at 6 to 8 weeks for presence of residual Barrett's Esophagus.

• Device: Cryoballoon Focal Ablation System - 6 seconds
  Ablation of Barrett's Esophagus using a Focal Cryoballoon ablation catheter. The System is a Class II device "intended to be used as a cryosurgical tool for the destruction of unwanted tissue in the field of general surgery, specifically for endoscopic applications."
• Device: Cryoballoon Focal Ablation System - 8 seconds
  Ablation of Barrett's Esophagus using a Focal Cryoballoon ablation catheter. The System is a Class II device "intended to be used as a cryosurgical tool for the destruction of unwanted tissue in the field of general surgery, specifically for endoscopic applications."

• Active Comparator: Cohort A
  Subjects in Cohort A will receive 6 seconds of Cryoballoon Focal Ablation to esophageal tissue.
  Intervention: Device: Cryoballoon Focal Ablation System - 6 seconds
• Active Comparator: Cohort B
  Subjects in Cohort B will receive 8 seconds of Cryoballoon Focal Ablation to esophageal tissue.
  Intervention: Device: Cryoballoon Focal Ablation System - 8 seconds

Inclusion Criteria:

1. Patients scheduled for ablation, EMR, and/or surveillance for BE (with or without dysplasia). Patient is 18 to 80 years of age at the time of consent (inclusive).
2. Patient has provided written Informed Consent (IC) using an Informed Consent Form (ICF) that has been approved by the Institution's reviewing IRB/EC.
3. Patient is willing and able to comply with all Clinical Investigation Plan (CIP) requirements.
4. Patient is deemed operable per standard institutional criteria.

Exclusion Criteria:

1. Patient with endoscopically active inflammation in the treatment zone
2. Esophageal stenosis preventing advancement of a therapeutic endoscope and/or within 4 cm of treatment zone.
3. Patient has a known history of unresolved drug or alcohol dependency that would limit ability to comprehend or follow instructions related to informed consent, post treatment instructions or follow-up guidelines.
4. Patient refuses or is unable to provide written informed consent.
5. Patients that are pregnant.